TARA MAE PETERSON (NPI# 1104474634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104474634 |
| Entity Type | Individual |
| Full Name | TARA MAE PETERSON |
| Practice Address |
9182 E Mogollon Trl Gold Canyon AZ 85118-7090 |
| Practice Telephone | 7609776305 |
| Mailing Telephone | 7609776305 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144619107 | Tara Danielle Peterson | Specialist/Technologist | 896 Ashe Loop Rd, Sylva, NC 28779-8810 | 2015-01-14 |
| 1700376969 | Tara Skelly Peterson | Dentist | 9042 Cahill Ave, Inver Grove Heights, MN 55076-3543 | 2018-05-14 |
| 1669971602 | Tara Peterson | Nurse Anesthetist, Certified Registered | 601 E Rollins St, Orlando, FL 32803-1248 | 2018-02-05 |
| 1053770867 | Tara Peterson | Marriage & Family Therapist | 1441 Constitution Blvd, Bldg 400 Ste 200, Salinas, CA 93906-3100 | 2016-02-22 |
| 1710353560 | Tara Anne Peterson | Nurse Practitioner | 13950 W Capitol Dr Ste 200, Brookfield, WI 53005-2441 | 2015-08-17 |
| 1174927867 | Tara Peterson | Behavioral Analyst | 424 Peninsula Ave, San Mateo, CA 94401-1653 | 2014-10-09 |
| 1659652956 | Tara Jo Peterson | Registered Nurse | 760 Hospital Circle, Browning, MT 59417-0730 | 2011-08-31 |
| 1336438811 | Tara Peterson | Marriage & Family Therapist | 1470 W Herndon Ave, Suite 300, Fresno, CA 93711-0552 | 2011-04-05 |
| 1588965933 | Tara Magen Peterson | Developmental Therapist | 2708 Ne 14th Street, Suite 5, Pompano Beach, FL 33062 | 2010-11-16 |
| 1235108457 | Tara L. Peterson | Nurse Practitioner | 8901 Indian Hills Dr, Suite 200, Omaha, NE 68114-4057 | 2006-03-17 |
| Street Address |
9182 E MOGOLLON TRL |
| City | GOLD CANYON |
| State | AZ |
| Zip Code | 85118-7090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255989190 | Christi Larson | Pharmacist | 6788 S Kings Ranch Rd, Suite 1, Gold Canyon, AZ 85118 | 2019-09-03 |
| 1962989244 | Deseret Medical Associates Plc | Chiropractor | 6410 S Kings Ranch Rd Ste 1, Gold Canyon, AZ 85118 | 2018-07-19 |
| 1467956425 | Gold Canyon Contemporary Dentistry | Dentist | 6900 E. Us Highway 60 Ste. #110, Gold Canyon, AZ 85118 | 2018-03-22 |
| 1699945998 | Randal Lavern Johnson | Pharmacist | 6832 S Kings Ranch Rd Ste 2, Gold Canyon, AZ 85118 | 2008-03-03 |
| 1649780420 | Ronald J Creasman | Internal Medicine | 3969 S Juniper Village Ct, Gold Canyon, AZ 85118-1700 | 2017-10-05 |
| 1033448352 | Mark Randall Grover | Social Worker | 6965 E Hacienda La Noria Ln, Gold Canyon, AZ 85118-1834 | 2009-12-15 |
| 1043418015 | Leslie D. Crabtree | Speech-Language Pathologist | 5044 S Las Mananitas Trl, Gold Canyon, AZ 85118-1847 | 2007-07-10 |
| 1366557381 | Bashas Inc | Pharmacy | 5311 S Superstition Mountain Dr, Gold Canyon, AZ 85118-1918 | 2006-08-20 |
| 1427665801 | Heargen LLC | Hearing Instrument Specialist | 5331 S Superstition Mountain Dr Ste C-107, Gold Canyon, AZ 85118-1921 | 2020-09-29 |
| 1841500824 | Gold Canyon Hearing, Pllc | Hearing Aid Equipment | 5331 S Superstition Mountain Dr, Suite C107, Gold Canyon, AZ 85118-1921 | 2010-10-08 |
| Find all providers in zip 85118 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669215 | Rhian Kay Sage | Student in an Organized Health Care Education/Training Program | 737 E Fillmore St, Tempe, AZ 85281-1142 | 2020-11-08 |
| 1730788928 | Gabriella Jones | Student in an Organized Health Care Education/Training Program | 12104 S 181st Dr, Goodyear, AZ 85338-7865 | 2020-10-20 |
| 1174122279 | Amanda Oas | Student in an Organized Health Care Education/Training Program | 6304 W Corrine Dr, Glendale, AZ 85304-1607 | 2020-10-20 |
| 1265039283 | Meghan Houston | Student in an Organized Health Care Education/Training Program | 3600 W Ray Rd Apt 2103, Chandler, AZ 85226-7719 | 2020-10-02 |
| 1992310312 | Jacob Richard Bromley | Student in an Organized Health Care Education/Training Program | 725 E Main St, Apt #1c, Somerton, AZ 85350 | 2020-09-11 |
| 1972118461 | Shanna Rae Begay | Student in an Organized Health Care Education/Training Program | 208 E Pine Knoll Drive Room 215 Building 66, Flagstaff, AZ 86011-0001 | 2020-09-10 |
| 1508470642 | Aisha J Ramirez-maya | Student in an Organized Health Care Education/Training Program | 5230 S 40th Pl, Phoenix, AZ 85040-3909 | 2020-09-05 |
| 1902410053 | Sanjhavi Agarwal | Student in an Organized Health Care Education/Training Program | 5850 E Still Cir Apt 2102, Mesa, AZ 85206-3618 | 2020-09-05 |
| 1003429846 | Krista Lyn Beerling | Student in an Organized Health Care Education/Training Program | 5827 E Indian School Rd, Phoenix, AZ 85018-6104 | 2020-08-30 |
| 1518570456 | Ashlyn Marie Herbert | Student in an Organized Health Care Education/Training Program | 2760 E Butler Ave, Flagstaff, AZ 86004-6001 | 2020-08-29 |
| Find all providers with the same taxonomy | ||||
| City | GOLD CANYON |
| Zip Code | 85118 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.